Individual
BLAISE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
69 SHIPWASH DR, GARNER, NC 27529-6860
(919) 772-1990
Mailing address
69 SHIPWASH DR, GARNER, NC 27529-6860
(919) 772-1990
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A15547
NC
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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